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Community Based Health Insurance Can Fight Malaria

Community-Based Health Insurance (CBHI) is seen as a way to promote universal health coverage and protect vulnerable populations from catastrophic financial effects of illness. Malaria can be such an illness is not treated in a timely manner, and having insurance can help prevent delays.

In countries including Rwanda, Burkina Faso and Senegal a particular CBHI scheme known as mutuelles has taken root. For Rwanda USAID (2018) reports that …

The 2014–2015 DHS showed that insurance coverage has remained stable since the 2010DHS and that 79 percent of the households have at least one family member with health insurance and that among those insured 97 percent have community health insurance (mutuelles). Early ANC attendance is also encouraged by providing targeted SBCC, combined with innovative community- and facility-level performance-based financing and high enrollment in community health insurance schemes (mutuelles). The MoH, with the support of partners, has worked to improve the quality of services for case management at health facilities through training and capacity building efforts at national and district levels.

A study looked at health care seeking for children below 5years of age in Rwanda in 2005 to 2010 and found that, “In both years,under-five children with Mutuelles were more likely to use medical care than uninsured children. Children in 2010 had a higher probability of using medical care … regardless of the children’s poverty or Mutuelles status.” The study provides an example of how pre-payment CBHI can not only increase universal health coverage but also address challenges of equity (Mejía-Guevara et al., 2015).

Below is a chart showing the fee structure in Rwanda (Tashobya, 2017). [The trainer should ask participants about fees for CBHIs or other national health insurance schemes in their countries if such exist and how participation in CHBI helps achieve UHC.]

Fees in Rwanda’s community insurance scheme, Mutuelles

Ubudehe/Social
Category

Annual
Rwandan Francs per Household Member

Approximate
US Dollars

1

0 (Paid by
government)

0

2

2,000

2.25

3

3,000

3.35

4

4,000

7.85

Now The East African reports that, “With more than 90 per
cent of Rwandans covered under the community-based health insurance scheme
locally known as Mutuelle de Santé, Rwanda is one of the few developing
countries in the world that have successfully achieved universal healthcare”
(Kagire, 2018) This was achieved by addressing enrollment, quality of cane and transferring
management of the scheme to the Rwanda Social Security Board (RSSB). Now more
than ever, no one needs to die from malaria in Rwanda.

https://t.co/yKKsmAEpSv @MinSanteRDC #Ebola 23 May 2019: Since beginning of epidemic, cumulative number of cases is 1,888, of which 1,800 confirmed 88 are probable. In total, there were 1,254 deaths (1,166 confirmed and 88 probable) and 492 people cured. 11 new confirmed cases